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极早产儿 3 岁内体格指标追赶生长的特征性研究

秦巧稚，赵雪琴 * 扫描二维码
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【摘要】 背景 随着围生医学的进步和发展，极早产儿的存活率明显升高。极早产儿生长发育落后会对其产生
长远影响，因此早期的追赶性生长极其重要，目前对极早产儿体格指标的长期追踪较少。目的 探讨极早产儿 3 岁内
体质量、身长、头围的增长趋势，促进科学追赶生长。方法 选取 2017 年 8 月至 2018 年 9 月在江苏省苏北人民医院
新生儿重症监护病房诊治的 120 例极早产儿（胎龄 28~32 周）为研究对象，其中小于胎龄儿（SGA）组 11 例，适于
胎龄儿（AGA）组 109 例，随机抽取同时间段出生的 121 例足月儿作为对照组。在矫正年龄 40 周，矫正年龄 3、6、
12、24 月龄，矫正年龄 36 月龄时进行体质量、身长、头围的测量，计算体格指标 Z 评分、生长速率。结果 SGA、
AGA 极早产儿组和足月儿组各项体格指标 Z 评分在矫正 12 月龄内比较，差异均有统计学意义（P<0.05）。AGA 极早
产儿组和足月儿组体质量追赶高峰出现在矫正 3 月龄前，SGA 极早产儿组体质量追赶峰值在矫正 3~6 月龄；AGA 极早
产儿组和足月儿组身长以矫正 6 月龄内增长趋势明显，SGA 极早产儿组身长在矫正 3~6 月龄之间出现追赶高峰；AGA
极早产儿组头围在矫正 3 月龄内追赶趋势明显，SGA 极早产儿组头围在矫正 3 月龄后追赶明显，矫正 12 月龄后逐渐
变缓。三组在矫正年龄 40 周 ~12 月龄的体质量生长速率比较，差异有统计学意义（P<0.05）；三组在矫正年龄 40 周
~24 月龄的身长及头围生长速率比较，差异均有统计学意义（P<0.05）。结论 3 岁内 SGA 极早产儿和 AGA 极早产儿
体格指标追赶趋势有差别，SGA 极早产儿各体格指标生长速度早期均落后于 AGA 极早产儿且追赶速度不均衡。极早
产儿早期体格追赶生长与足月儿有明显的差距，组内不同体格指标出现追赶高峰的时间点不同。
【关键词】 婴儿，极度早产；小于胎龄儿；适于胎龄儿；Z 评分；追赶生长
【中图分类号】 R 722 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2021.01.604
秦巧稚，赵雪琴 . 极早产儿 3 岁内体格指标追赶生长的特征性研究［J］. 中国全科医学，2022，25（8）：913-
917，923. ［www.chinagp.net］
QIN Q Z，ZHAO X Q. Longitudinal study of catch-up growth assessed by anthropometric parameters in very premature
infants within 3 years old［J］. Chinese General Practice，2022，25（8）：913-917，923.

Longitudinal Study of Catch-up Growth Assessed by Anthropometric Parameters in Very Premature Infants within 3
Years Old QIN Qiaozhi，ZHAO Xueqin *
Northern Jiangsu People' s Hospital，Yangzhou 225000，China
*
Corresponding author：ZHAO Xueqin，Associate chief physician；E-mail：603561312@qq.com
【Abstract】 Background The improvement in perinatal medicine has promoted the increase of survival rate in very
premature infants. Since growth and developmental delays will have a long-term impact on them，early catch-up growth is
extremely important. However，there are few longitudinal studies on anthropometric parameters for assessing catch-up growth in
such infants. Objective To investigate the increasing trend of body weight，body length and head circumference（HC） of very
premature infants within 3 years old，providing evidence for promoting scientific catch-up growth in such infants. Methods
Participants were selected from Northern Jiangsu People's Hospital during August 2017 to September 2018，including 120 ICU-
treated very premature infants delivered at 28-32 weeks of gestation，who were divided into two group 〔small for gestational
age（SGA）group（n=11） and appropriate for gestational age（AGA）group（n=109）〕，and 121 full-term infants.
Body weight and length as well as HC were measured at 40 weeks，3，6，12，24 months of corrected age and 36 months，
respectively，and Z-scores and growth rates of these three parameters were calculated. Results The Z-scores of body weight，
body length and HC differed statistically across SGA，AGA and full-term infants within 12 months of corrected age（P<0.05）.
The catch-up growth for weight peaked within 3 months of corrected age in AGA infants and full-term infants，and it peaked
within 3 to 6 months of corrected age in SGA infants. The growth for height showed a significant increase trend within 6 months
of corrected age in AGA and full-term infants. For SGA infants，the catch-up growth for height peaked within 3 to 6 months of
基金项目：江苏省妇幼保健协会科研项目（FYX202022）
225000 江苏省扬州市，江苏省苏北人民医院
*
通信作者：赵雪琴，副主任医师；E-mail：603561312@qq.com
本文数字出版日期：2021-01-28